经股动脉与经桡动脉肾动脉造影及支架置入的安全性和有效性比较  

Safety and efficacy of renal arteriography and stenting via femoral versus radial access:A comparative study

作　　者：刘继轩 陈光辉[1] 孙志军[1] 蒋博[1] 王锦达[1] 

机构地区：[1]解放军总医院心血管内科,北京100853

出　　处：《解放军医学院学报》2016年第6期529-531,551,共4页Academic Journal of Chinese PLA Medical School

基　　金：国家自然科学基金项目(81270272)~~

摘　　要：目的评价分别经股动脉和经桡动脉行肾动脉造影的安全性和有效性。方法选取2008年1月-2015年4月在我院住院的肾动脉狭窄患者,分别采取经股动脉、经桡动脉肾动脉造影术,记录并比较两组患者X线照射时间、手术时间、造影剂用量、造影成功率、舒适度评分、卧床时间、并发症发生率;行肾动脉支架置入治疗的患者,比较手术成功率和术后再狭窄率。结果经股动脉造影1 286例,男性663例,女性623例,年龄41～82(64.4±8.2)岁;经桡动脉造影463例,男性275例,女性188例,年龄40～80(61.2±8.5)岁;两组患者年龄、性别等差异无统计学意义(P>0.05)。经股动脉造影与经桡动脉造影X线照射时间[(2.08±0.16)min vs(4.14±0.23)min]、手术时间[(5.37±1.78)min vs(9.06±2.58)min]有统计学差异(P<0.05),造影剂用量[(14.27±3.65)ml vs(15.09±3.48)ml)]、造影成功率(99.84%vs 99.35%)及总体并发症发生率(3.65%vs 4.10%)无统计学差异(P>0.05)。经桡动脉造影组舒适度评分高于经股动脉组(57.2±11.3 vs 34.6±6.1,P<0.05)。经桡动脉组造影术后卧床时间短于经股动脉组[(1.5±0.42)h vs(23.2±1.65)h,P<0.05]。经桡动脉与经股动脉行肾动脉治疗支架置入成功率(97.02%vs 98.83%)与术后6个月支架内再狭窄率(6.93%vs 5.81%)无统计学差异(P>0.05)。结论经桡动脉造影及支架置入治疗创伤小,患者术后无需长时间卧床,术后不适反应少。Objective To evaluate the safety and efficacy of two different approaches of renal arteriography（femoral access vs radial access）. Methods Patients with renal artery stenosis who underwent renal arteriography via femoral artery or radial artery in Chinese PLA General Hospital from January 2008 to April 2015 were included. X-ray exposure time, procedure time, dose of contrast agent, success rate of arteriography, comfort level, time in bed and complication rate were recorded, and the success rate of stenting and restenosis rate were compared in patients with renal artery stenting. Results Of the 1 286 cases with femoral arteriography, there were 663 males and 623 females with average age of（64.4±8.2） years（ranging from 41-82 years）. Four hundred and sixty-three patients underwent renal arteriography via radial artery, including 275 males and 188 females with average age of（61.2±8.5） years（ranging from 40-80 years）. No significant difference was found in sex and age between two groups（P〈0.05）. X-ray exposure time [（2.08±0.16） min vs（4.14±0.23） min] and procedure time [（5.37±1.78） min vs（9.06±2.58） min] of femoral artery group were shorter than radial artery group（P 0.05）. The comfort level of radial artery group was higher than femoral artery group [（57.2±11.3） vs（34.6±6.1）, P 0.05], while the time in bed of radial artery group was shorter than femoral artery group [（1.5±0.42） h vs（23.2±1.65） h, P 0.05]. There were no significant differences in the dose of contrast agent [（14.27±3.65） ml vs（15.09±3.48） ml], success rate（99.84% vs 99.35%） of angiography, complication rate（3.65% vs 4.10%）, stenting success rate（6.93% vs 5.81%） and restenosis rate（6.93% vs 5.81%） between two groups（P 0.05）. Conclusion Patients with renal arteriography and stenting via radial access achieve better efficacy with less trauma, short time in bed and less adverse reaction.

关 键 词：肾动脉狭窄 经股动脉 经桡动脉 肾动脉造影术 

分 类 号：R692[医药卫生—泌尿科学]